Lessons Learned from COVID-19: Public Health Recommendations for Future Pandemics (Part II)
The first blog in this two-part series focused on local and federal policymaker recommendations based on several communication, leadership, and disaster recovery failures that made themselves apparent during the pandemic. This blog will specifically discuss public health recommendations for future pandemics based on the concerns exposed during the COVID-19 pandemic.
COVID-19 has brought to light many fundamental problems in our nation’s public health disaster response, and underscored the importance of improving our preparedness for the next disease disaster.
Healthcare Supply Shortages
In the first few months of the pandemic, response materials such as KN95 protective masks, ventilators, and other personal protective equipment (PPE) were in short supply. Healthcare workers were left without the ability to protect themselves and their patients. Almost 90% of frontline workers reported a higher rate of repeated reuse of single-use surgical masks in 2020, a phenomenon that leads to a 46% increase in the risk of contracting COVID-19.
Panic buying, hoarding, and misuse exacerbated the problems. Hoarding leads to more hoarding as people become afraid that they will miss out, so an anti-panic strategy that combines communications, effective inventory management, swift operational fulfillment, and point of sale purchase management can ensure adequate supplies.
At the point of sale, consumers need to be informed about the importance of assisting the public health system to triage health supplies, and other strategies like “limit two per customer” or limiting the amount of people allowed in a store at a time should be implemented. Acts of generosity promote cooperation, so increasing the visibility of healthcare workers' good deeds and needs might encourage more prudent purchasing and lessen the pressure on the supply chain.
To enhance critical product inventory management, part of the United States Department of Health and Human Services’ (HHS) or the Federal Emergency Management Agency’s (FEMA) budget should be allocated to developing a list of critical products including PPE, supplies for babies, essential medicines that might have significant social and public health consequences, and more. A 2022 report from the National Academies poses a useful framework for selecting such products based on three considerations:
expected harm a given product user would undergo in a shortage,
the magnitude of a potential shortage, and
the probability that a product might experience a shortage.
This funding could be recuperated from disaster response costs saved, as it is generally less costly to avoid public harm through preparedness measures. Capacity building can then be implemented through a combination of regulatory changes and economic incentives that encourage healthcare facilities and corporations to maintain a sufficient stock of these resources.
Protections for the Elderly: Retirement Communities and Nursing Homes
Long-term care facilities (LTCFs) were unprepared to handle COVID. This was a major problem because of their housing of dense concentrations of people with underlying comorbidities who face higher risks of life-threatening COVID-19 symptoms.
At the beginning of the pandemic, LTCFs made up nearly half of COVID-19 deaths nationally. By February 2022, they made up about 23% of COVID-19 deaths. With each new surge, LTCFs continue to experience disproportionately high case and death rates. By March 2023, there were 165,167 COVID deaths among LTCF residents, 14.7% of the nation’s 1,125,366 COVID deaths.
Improvements must be made in infection prevention and mitigation plans at LTCFs. These facilities should keep a stockpile of PPE for other contagious diseases. Additionally, a plan needs to be made for staff who work at multiple care facilities, as many LTCF workers do because of the low wages. Eliminating staff linkages between facilities could have reduced COVID-19 infections in nursing homes by half. For further disease mitigation planning, the CDC has provided LTCFs with a list of infection prevention tools, guidelines, and checklists here.
In an interview with architect Eric Endres, who specializes in senior living design, ISD learned a few ways in which structural design changes can facilitate disease prevention in LTCFs. Firstly, make LTCF buildings less reliant on touch, such as by using sensor-controlled automatic doors, in order to prevent bacteria spread. Social distancing can also be subconsciously encouraged in unique ways, such as spacing artwork six feet apart or using carpeting that has spaced patterns. Creating outdoor community spaces can provide LTCFs with safe spaces to have outdoor dining and activities for their residents. These changes can alleviate the physical challenges of isolation and ensure residents’ mental well-being during difficult times.
With any new disease outbreak, finding a medical solution or prevention becomes one of the priorities in public health response. However, with the COVID-19 virus, vaccines became one of the most polarizing parts of the pandemic. As of March 29, 2023, 81% of Americans received at least one dose of the vaccine, and 69% were fully vaccinated with two doses. By October 19, 2022, 34% of Americans had received a booster shot.
More publicly available information about the vaccine and less discussion of it as a panacea could have appeared less biased, increased public trust, and boosted vaccination rates.
Acknowledging that the vaccine would not equate to an immediate return to normal could have managed expectations and increased confidence in it as one of many steps in fully recovering public health. Long after the vaccine was available, it was still necessary to remain masked and practice social distancing. Many schools were still hybrid, if not completely virtual, and numerous universities had to revert to online classes to protect students when infections surged. This left some Americans frustrated due to assumptions that the vaccine would bring a quick conclusion to the pandemic, a preventable outcome that increased discontent with and distrust of the vaccine.
Although the COVID-19 vaccine did not end the pandemic, vaccination does lead to:
90% reduction in risk for severe COVID-19 outcomes,
79% effectiveness against mechanical ventilation and in-hospital death for recipients of two doses,
and 94% effectiveness against mechanical ventilation and in-hospital death for recipients of three doses.
On the local and state level, tailoring health communications to specific audiences could have helped with vaccine uptake and increased public knowledge of its community-wide impacts. Focusing on audience motivations to get vaccinated will make the message most compelling. For example, younger people may not be as concerned about their own health but are driven by an urge to protect older family members.
Although the pandemic is not over yet, our public health systems need to continue to improve for the future. Taking action to prevent supply shortages, protect the elderly in LTCFs, and create more effective vaccine messaging will improve pandemic prevention and mitigation across the country.
Find COVID-19 resources here.
Disclaimer: The views and opinions expressed here are those of the authors and do not necessarily reflect the official policy or position of the Institute for Sustainable Development (ISD). Any content provided by our bloggers or authors are of their opinion, and are not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything. ISD values and welcomes diverse representations and opinions.